Genetics, growth plate are stature factors

As far back as I can remember, I was always the shortest kid in my class. It never bothered me, however, because I got to be in the front of all the lines and I usually was more preoccupied with maintaining my status as the loudest and smartest kid in the room.

Because I am descended from a long line of short (and loud and smart) people, no one thought I was particularly out of the ordinary, but many parents are quite concerned about their child's height, especially if he seems smaller than his friends.

Short stature refers to a child who is significantly below average in height, sometimes defined as the shortest 1 percent to 2 percent of the population. Your doctor will measure your child and plot his height on a growth chart to see how he is growing over time and compare him to other children of the same age and gender.

Most cases of short stature are not associated with any type of disorder or illness. The most common cause of short stature is genetic (also known as familial). In simple terms, short parents tend to have short kids. Although other factors contribute to his eventual size, you can obtain a rough estimate of your child's final adult height by calculating the average of mom and dad's height and adding 2.5 inches for a boy or subtracting 2.5 inches for a girl.

Another common reason that a child may be small for his age is Constitutional Growth Delay, also known as being a "late bloomer." These children start puberty a little later then their peers and have a late growth spurt. Even though they may be shorter for awhile, they continue to grow and eventually catch up or pass their friends in height by the time they are an adult. This often runs in families, so if dad was a late bloomer, his son may follow the same growth pattern.

Growth hormone deficiency is a rare cause of short stature in children. If the pituitary gland in the brain doesn't secrete enough growth hormone, your child's rate of growth can slow considerably, resulting in decreased total height. (After 2 years of age, children typically grow about 2½ inches per year until puberty.)

If after careful examination of family history and a review of the growth chart your doctor suspects that your child has a medical reason to be short, you will need to have some blood work done to check growth hormone levels and may have other laboratory studies. Your child also may need an X-ray to evaluate how his bones and growth plates are developing, since this also can help determine the diagnosis.

If your child is growth hormone deficient, he may be treated with replacement growth hormone, given as a daily shot. In certain cases, children who are extremely short with normal growth hormone levels and no other explanation for their height (known as idiopathic short stature) also may qualify for growth hormone injections. Your doctor can refer you to a specialist (pediatric endocrinologist) to discuss the risks and benefits of growth hormone therapy.

Kids can get teased about anything that makes them different, but you can encourage your child not to let his height define him or change how he feels about himself. President James Madison and Beethoven both were significantly shorter than average, but that didn't stop them from rising to great heights.

Dr. Betsy Neahring practiced pediatrics in Evansville for 10 years before (mostly) retiring to become "Daniel's Mom." Write to her at drbetsyneahring@aol.com.